| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,791 |
1,463 |
$72K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
685 |
556 |
$23K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
751 |
365 |
$20K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
15 |
12 |
$15K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
320 |
268 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
105 |
90 |
$7K |
| 76830 |
Ultrasound, transvaginal |
55 |
54 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
44 |
41 |
$2K |
| 81025 |
|
980 |
812 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
24 |
12 |
$1K |
| 99385 |
|
13 |
12 |
$892.88 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
66 |
51 |
$674.13 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
13 |
$598.53 |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
16 |
15 |
$553.56 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
187 |
156 |
$401.80 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
30 |
30 |
$272.22 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$43.95 |
| 81002 |
|
20 |
20 |
$21.56 |
| 81003 |
|
42 |
24 |
$18.90 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
137 |
114 |
$0.00 |
| 99080 |
|
218 |
122 |
$0.00 |
| 99024 |
|
167 |
142 |
$0.00 |